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目的 总结胰腺钩突部癌的临床特点及提高手术切除率的措施。方法 1990年 1月至 1999年 6月 ,我院对 10例胰腺钩突部癌行胰十二指肠切除术 ,其中 7例联合门静脉 (PV)和肠系膜上静脉 (SMV)切除 ,有 5例切除静脉干长度为 2 0～ 4 2cm ,直接对端吻合成功 ;有 2例行受浸润血管侧壁切除修补术。门静脉阻断时间为 8～ 40min ,未同时阻断肠系膜上动脉。结果 联合PV、SMV切除的 7例中 ,有 1例术后 3d因肝功能衰竭死亡 ,1例术后出现乳糜样腹水 ,5例术后生存 13～ 2 9个月 ;未联合静脉切除的 3例中 ,有 2例分别存活 13个月和 14个月 ,有 1例已存活 11 5个月。结论 胰腺钩突部癌常侵犯邻近血管 ,对门静脉受侵犯者仍有可能行根治手术。
Objective To summarize the clinical features and improve the surgical resection rate of pancreatic uncinate process. Methods From January 1990 to June 1999, 10 cases of pancreatoduodenectomy of pancreatic cancer were performed in our hospital. Among them, 7 cases had combined portal vein (PV) and superior mesenteric vein (SMV) resection, and there were 5 cases. The length of excised veins was 20 to 42 cm, and the direct anastomosis was successful. There were 2 cases of invasive vascular wall resection and repair. The portal vein block time was 8 to 40 minutes and did not block the superior mesenteric artery at the same time. Results Of the 7 patients who underwent PV and SMV resection, 1 patient died of hepatic failure 3 days after surgery, 1 patient developed chylous ascites after surgery, and 5 patients survived 13 to 29 months; 3 patients who did not undergo venous excision 3 In the example, 2 cases survived 13 months and 14 months respectively, and 1 case had survived 11 5 months. Conclusion The cancer of the pancreatic uncinate process often invades adjacent blood vessels, and it is still possible to perform radical surgery on the portal vein.